What do we know about OPCAB surgery?
Coronary revascularization with extracorporeal circulation (ECC) was established in the 1960s; since then, this technique has evolved into a routine clinical tool. In view of typical mortality rates of 2-5%, the method is generally considered safe. Increasing standardization of the surgical approach and enhanced ECC techniques have led to expanded indications, and subsequently to increasing numbers of elderly patients and patients with multiple morbidities undergoing surgery. These expanded indications confronted us with postoperative complications in patients with complex comorbidities, eventually resulting in higher morbidity and mortality rates and therefore in a higher use of resources. There is a variety of surgical complications which can affect several organ systems. In addition to postoperative hypoperfusion with or without myocardial pump failure, neurological, pulmonary, and renal complications are frequently seen. We should aim at developing therapeutic strategies that minimize surgical trauma without compromising the high safety of the standard approach. In more and more patients, preoperative organ function is already at the brink of decompensation, and the response to an invasive surgical procedure may be enough to threaten this fragile equilibrium.
KeywordsCoronary Artery Bypass Cardiopulmonary Bypass Myocardial Revascularization Cardioplegic Arrest Postoperative Stroke
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